NPI | 1245765585 |
---|---|
Entity Type | Organization |
Authorized Contact | MEGAN THOMAS Operations Specialist For Strategic 800-805-6989 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM2800X Clinic/Center, Methadone Clinic |
Additional Taxonomies | 251S00000X |
261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
261QM1300X Clinic/Center, Multi-Specialty | |
261QP2300X Clinic/Center, Primary Care | |
261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
Enumeration Date | 2017-04-24 |
Last Update Date | 2022-06-18 |